Long Island Community Hospital
Overview
Long Island Community Hospital sponsors a self-funded health plan that covered 745 participants in plan year 2024. The plan year starts in January. Alongside medical, its benefits filing reports life insurance, dental, vision, long-term disability, and more.
- Plan type
- ERISA welfare benefit plan, self-funded (benefits paid from employer assets or a trust)
- Participants
- 745
- Plan year
- Begins January 1 · next renewal January 2027
- Health plans filed
- Long Island Community Hospital Employee Health and Welfare Benefit Plan, plan 503 (745 participants)
- Broker compensation
- $4K across insured contracts
Insurance carriers
Insured coverage reported on Schedule A. Self-funded medical claims aren't reported there.
| Carrier | Coverage | Covered | Premium | Broker comp |
|---|---|---|---|---|
| New York Life Group Insurance Company of New York | Long-term disability, Life | 991 | $164K | $-7K |
| The Guardian Life Insurance Companyof America | Dental | 720 | $112K | $11K |
| Anthem Blue Cross | Vision | 1,516 | $58K | — |
Pharmacy benefit estimate
StreamRX estimate for a plan this size. Not based on this plan's claims.
Estimated prescription spend: 745 participants × $2,371 national average per member. Usually higher once dependents are counted.
Typical savings opportunity found in independent reviews of plans this size.
Form 5500 filing details
- Filing
- Form 5500 with Schedule A, plan year 2024
- Plan sponsor
- Long Island Community Hospital
- Sponsor EIN
- 11-1704595
- Plan number
- 503
- Filed with
- U.S. Department of Labor (EBSA) via EFAST2
Verify this filing: search EIN 11-1704595 in the Department of Labor's EFAST2 Form 5500 search.
Retirement plan
- Plan
- Brookhaven Memorial Hospital Medical Center DBA Long Island Community Hospital Retirement Savings Plan
- Type
- 401(k) plan
- Participants
- 2,804
About this data
Source: Long Island Community Hospital's Form 5500 filing for plan year 2024 and its Schedule A insurance reports, published by the U.S. Department of Labor. "Self-funded" means the filing reports benefits paid from employer assets or a trust, with no medical insurance contract or with a stop-loss contract. Pharmacy figures are StreamRX estimates based on national averages. StreamRX is not affiliated with Long Island Community Hospital.